What are Signs of Nursing Home Abuse?

Signs of nursing home abuse

Nursing home abuse can be devastating to the elderly person who experiences it, as well as their families and friends who witness it. It may involve intentionally causing harm, or neglecting to provide the elderly person with proper care.

The abuser is often someone that the elderly person should be able to trust, such as a caregiver or relative. Unfortunately, for a variety of reasons, the abuser may take advantage of the relationship and cause mental or physical harm.

Incidents of nursing home abuse are quite common in the United States, so it is very important to recognize the signs that it may be occurring.

Common Signs of Physical Abuse in Nursing Homes

Once you know what to look for, it is easier to determine whether an elderly resident is being physically harmed.

Common signs of physical abuse include:

  • Bruises, black eyes, welts, lacerations, or rope marks
  • Bone fractures, broken bones, or skull fractures
  • Open wounds, cuts, or wounds that do not heal
  • Sprains or dislocations
  • Broken eyeglasses or other signs of being physically mistreated
  • Signs of bodily injury
  • Medication overdoses or under-utilization of prescribed drugs
  • Changes in behavior
  • Elderly person reports being hit, slapped, or otherwise injured

If you notice any of these signs of abuse, it is important to take action and ask for additional help.

Common Signs of Emotional Abuse in Nursing Homes

Evidence of emotional abuse isn’t always immediately apparent. A sudden change in behavior is often a red flag that an issue exists. You may also witness a situation where another person is controlling a vulnerable elderly person in an inappropriate way.

Other warning signs to look for include:

  • Being emotionally upset or agitated
  • Seeming unusually withdrawn, non-communicative, or non-responsive
  • Odd behavior, including sucking, biting, or rocking
  • Changes in sleeping patterns or eating habits
  • Changes in personality
  • Depression or anxiety
  • An older person’s report of being mistreated

While psychological abuse won’t leave physical marks on an older person, it can lead them to act in unusual ways.

Common Signs of Sexual Abuse in Nursing Homes

Sexual abuse is the least common form of abuse experienced by people in nursing home facilities. However, it does occur.

Common red flags include:

  • Bruises around the breast or genital area
  • Unexplained venereal disease or genital infections
  • Irregular vaginal or anal bleeding
  • Showing fear or agitation when a particular person is around
  • Pornographic material being shown to an older adult with intellectual impairments
  • Blood found on sheets, linens, or clothing

If you see warnings of sexual abuse, it’s important to have the elderly person examined immediately and try to determine who is performing the abuse.

Common Signs of Neglect in Nursing Homes

Dehydration and malnutrition due to neglect is a very common occurrence, especially in nursing homes or assisted living facilities. Oftentimes these places are understaffed, and if an elderly person doesn’t have trusted family or friends checking in on them regularly, there may not be as much pressure on staff to ensure they receive adequate care.

Signs of neglect can include any of the following:

  • Dehydration and malnutrition
  • Untreated bedsores
  • Poor personal hygiene
  • Medication errors
  • Unattended or untreated health problems
  • Hazardous or unsafe living arrangements
  • Unsanitary living conditions, such as soiled bedding, strong odors, or inadequate clothing
  • Abandoning an older adult at a hospital, nursing facility, or other public location
  • Lack of food available in refrigerators or cupboards
  • Elder’s reports of being neglected or abandoned

If you visit your elderly family member and see that they are not adequately taken care of, it is important to step in and ensure they get the assistance they need. You may need to visit more often or have them transferred to a more attentive facility. If this is a regular occurrence or if the neglect is severe, you should file a report.

Common Signs of Financial Abuse in Nursing Homes

Many elderly individuals fall prey to financial abuse. They may have mental limitations that prevent them from understanding when they are being taken advantage of monetarily.

Indications of financial abuse to look out for are:

  • Changes in bank accounts or banking practices
  • Unexplained withdrawal of large sums of money by someone accompanying the elderly individual
  • Inclusion of additional names on the person’s bank signature card
  • Abrupt changes in a will or other financial document
  • The disappearance of funds or valuable possessions
  • Unpaid bills despite the availability of funds
  • Forged signatures for financial transactions or titles to possessions
  • Uninvolved relatives who appear and want rights to the elderly person’s property or possessions
  • The sudden transfer of assets to a family member or another individual
  • Provision of services that aren’t necessary
  • An older adult’s report of financial exploitation
  • Unexplained credit card charges

If an elderly person is unable to fully look after their finances, it may be best to hire an independent trustee who can provide a duty of care and ensure their finances are properly maintained. This is especially true if there are divisions in the family or if people close to the elderly person show signs of financial distress.

Risk Factors for Nursing Home Abuse

There are a number of risk factors that can increase the chance of an elderly person falling prey to abuse. These may be traits associated with the victim or with the perpetrator. They can also be associated with the living environment itself.

Common elements or traits of elderly individuals who experience such abuse include the following:

  • Chronic medical conditions and poor physical health
  • Functional disability and dependence
  • Mental health problems
  • Cognitive deficits
  • Financial dependence
  • Lower socioeconomic status
  • Substance abuse
  • High levels of stress and poor coping mechanisms
  • Prior exposure to trauma
  • Limited social support
  • Poor relationship between the victim and the perpetrator

Women are more frequently victims of abuse than men are, and African-Americans tend to suffer a higher rate of abuse than white Americans. While all of these aspects may factor into the risk of abuse, no two cases are the same. Just because a risk factor exists does not mean that abuse will occur.

It’s also important to consider the risk factors associated with an individual who has abusive traits. Red flags that a caregiver might become an abuser include:

  • Chronic medical conditions and poor physical health
  • Mental health problems
  • Cognitive deficits
  • Financial dependence
  • Substance misuse
  • High levels of stress and poor coping mechanisms
  • Negative attitudes toward the older adult
  • Early childhood abuse

Many of the traits associated with a person who is more likely to commit abuse are similar to the victim’s traits. If the abuse occurs between family members, there may be a history of conflict within the family extending all the way back to childhood.

When an elderly person is put in a nursing home, there may be a risk of abuse if the facility is understaffed or has a history of poor care. While it may not be possible for the elderly individual to live on their own or with a family member, it’s important to choose a facility with a strong reputation for maintaining the health and sanitation practices of its patients.

Before selecting a home, ensure that you perform significant research. Visit it to see if patients seem happy and taken care of. Speak with nurses and other staff members and observe the level of cleanliness in the facility. If it seems worn-down, smelly, or dirty, it is likely not somewhere you would want your loved one to spend their days.

What to Do If You Suspect Abuse in a Nursing Home

Whether you are a family member or friend of a nursing home resident or an employee or contractor of a nursing home, you should always be alert for signs of abuse of the elderly.

Many elders aren’t in a position to defend themselves or to ensure that they are being treated fairly. Checking in on them regularly and notifying staff if there appears to be an issue can go a long way to improving their well-being in their later years.

If abuse seems to be severe or continuous, it is important to document it and give details of signs and patterns to the nursing home administration.

If nothing changes, reach out to your state government for assistance. They have advocates who work on behalf of elderly individuals who are residents in nursing homes or other similar types of facilities.

For example, the Administration of Aging oversees the Long-Care Ombudsman Program. You can find the contact information for your state through the Consumer Voice website.

In addition to the Long-Care Ombudsman Program, Adult Protective Services can also assist with filing a report of suspected elderly abuse.

If you suspect nursing home abuse or wrongful death, reach out to us for a free case review. We can listen to your concerns and assist you with documentation to ensure the elderly person in your life receives the care that they deserve.

Medically Reviewed by:

Dr. Patricia Shelton, MD

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  • University of Washington, Doctor of Medicine – MD. June 2008
  • University of Washington, Bachelor of Science – BS, Jun 2003


Neuroscience and Medicine


  • Dr. Shelton primarily writes content for health-related websites, but has also written test prep materials, white papers, published research articles, court documents, and more.
  • Dr. Shelton teaches anatomy and physiology at the college level for the National Institutes of Health.

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Nursing Home Abuse Should Have Consequences.

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Our fact-checking process begins with a thorough review of all sources to ensure they are high quality. Then we cross-check the facts with original medical or scientific reports published by those sources, or we validate the facts with reputable news organizations, medical and scientific experts and other health experts. Each page includes all sources for full transparency.
Our fact-checking process begins with a thorough review of all sources to ensure they are high quality. Then we cross-check the facts with original medical or scientific reports published by those sources, or we validate the facts with reputable news organizations, medical and scientific experts and other health experts. Each page includes all sources for full transparency.